Special risk groups

In low risk areas, antimalarials may be considered in exceptional circumstances for travellers who are at higher risk of malaria (such as long term travellers visiting friends and relatives), or of severe complications from malaria (such as the elderly [>70 years], the immunosuppressed, those with complex co-morbidities, pregnant women, infants and young children).

Travellers with an absent or poorly functioning spleen should be dissuaded from travel to any area with risk of malaria, but where travel is essential awareness, rigorous bite avoidance and antimalarials should be advised.

VACCINATIONS

TyphoidVaccination could be considered for travellers whose activities put them at increased risk, including those visiting friends and relatives, and frequent or long-stay travellers to areas where sanitation and food hygiene are likely to be poor.

Hepatitis AVaccination recommended for all previously unvaccinated travellers. Hepatitis A vaccine is well tolerated and affords long-lasting protection.

RabiesVaccination recommended for travellers whose activities put them at increased risk, including those at risk due to their work (eg, health workers or those working with animals), those travelling to areas where access to post-exposure treatment and medical care is limited, those planning higher risk activities such as running or cycling, and long-stay travellers.

Yellow feverVaccination is recommended for travellers 9 months of age and older travelling to mainland regions of Emberá and Kuna Yala, the province of Darién, and areas of the province of Colón and Panama that are east of the Canal Zone.

Vaccination is not recommended for travel only to Panama City, the Canal Zone, the Balboa (Pearl Islands) and San Blas islands, and areas west of the Canal Zone.

If a receiving country requires an ICVP as a condition of entry, and the individual should not receive the vaccine on medical grounds, a letter of medical exemption can be considered.

TetanusTravellers should have completed a primary vaccination course according to the UK schedule. If travelling to a country where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously.

TuberculosisVaccination recommended for travellers at increased risk of developing severe disease and/or of exposure to TB, including unvaccinated children under 16 years of age who are going to live for more than 3 months in this country and unvaccinated, tuberculin skin test negative individuals under 35 years of age at risk because of their work (eg, healthcare workers, prison staff and vets).

Further information

Abbreviated information provided by the National Travel Health Network and Centre (NaTHNaC). Refer to the Panama page on travelhealthpro.org.uk for full details.

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